1831375039 NPI number — MS. DENNIFER D HARDY A.R.N.P

Table of content: MS. DENNIFER D HARDY A.R.N.P (NPI 1831375039)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831375039 NPI number — MS. DENNIFER D HARDY A.R.N.P

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARDY
Provider First Name:
DENNIFER
Provider Middle Name:
D
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
A.R.N.P
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MAYO
Provider Other First Name:
DENNIFER
Provider Other Middle Name:
D
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1831375039
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/17/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 587
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUGUSTA
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04332-0587
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-509-3271
Provider Business Mailing Address Fax Number:
207-660-4203

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
193 FRONT ST
Provider Second Line Business Practice Location Address:
SUITE 5
Provider Business Practice Location Address City Name:
FARMINGTON
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04938-5834
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-778-4553
Provider Business Practice Location Address Fax Number:
207-778-2041
Provider Enumeration Date:
01/17/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LX0001X , with the licence number:  ARNP 3019442 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)